St. Paul, Minn. —
(AP) - Four people on Minnesota's low-income Medical
Assistance program on Monday filed what they intend to be a
class-action lawsuit, alleging a 2003 law requiring them to pay
co-payments for medication and doctors' visits violates federal
Medicaid law.

As part of a budget fix, the state demanded new co-payments for
prescription drugs, eyeglasses and doctor and hospital visits. The
fees are capped at $20 per month for medications plus $3 per
medical visit, but Sue Abderholden of the National Alliance for the
Mentally Ill, which joined the lawsuit, said the fees quickly
overwhelm people who live in group homes or adult foster care.

"These are clearly people who do not have a discretionary
income," she said. "You put people, really, between a rock and a
hard place. What do they give up?"

Jeffery Dahl, a plaintiff from St. Cloud who has a
disease that has cost him the use of his arms and legs, said he's
given up all entertainment spending.

He said all but $94 of his $695 Social Security income pays for
his board and care, and the remaining money is to pay for his
clothing, personal needs and, since the law went into effect in
October, his co-payments.

Every year it seems poor and disabled people lose more of the benefits they've been getting.- Jeffery Dahl, plaintiff

Unable to pay, he said he has gone into debt and had one
pharmacy refuse to serve him. A second has now threatened to do the
same.

"Every year it seems poor and disabled people lose more of the
benefits they've been getting," he said.

The suit, filed in Ramsey County District Court, alleges the
state Department of Human Services violated federal Medicaid law by
failing to notify some recipients of both the new payments and
their right to avoid the fees if they're unable to pay.

More pointedly, it alleges that a provision of state law that
allows medical providers to refuse service to a person who has a
co-payment debt, if that's their routine practice, directly
violates federal law. In those cases, they can refuse service even
if a person says they're unable to pay.

In a written statement, Commissioner Kevin Goodno said the state
is in compliance.

"The federal government has approved the copay provisions of
our state plan - the formal plan for administering the Medicaid
program in Minnesota."

He said he couldn't comment further.

Ralonda Mason, attorney for the group, said she will ask the
Ramsey County District Court to grant the lawsuit class-action
status. The lawsuit seeks to repeal the co-payments and reimburse
people who were wrongly charged.